substance abuse presentation revised
TRANSCRIPT
8/3/2019 Substance Abuse Presentation Revised
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Substance Related DisordersPresented by: Jeannie Vargas
and Toluwalase Ekundayo
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Objectives
• Definitions
• Diagnostic Criteria (DSM-IV TR)
•
Substance Use vs. Substance Induced• Treatment Plans
• Proposed Changes in DSM-5
•
Community resources• References
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Substance Related Disorders
• Substance related disorders include disorders related to the taking of
a drug of abuse, to side effects of a medication, and to toxin
exposure.
• The DSM-IV TR has eleven classes of substance: alcohol,
amphetamines, caffeine, cannabis, cocaine, hallucinogens, inhalants,nicotine, opioids, phencyclidine, sedatives, hypnotics, or
anxiolytics.
• Most of the eleven classes has criteria for either dependence, abuse,
intoxication, or withdrawal.
• Substance related disorders are divided into two groups: the
Substance Use Disorders and the Substance Induced Disorders.
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Substance Use Disorder: Substance
Dependence• Substance Dependence is a cluster of cognitive (tolerance), behavioral
(withdrawal), physiological (compulsive drug-taking behavior)symptoms indicating that the individual continues use of substancedespite significant substance related problems.
• Dependence is defined as a cluster of three or more symptoms listedbelow occurring at any time in the same 12-month period.
• Specifiers are provided to note the presence and absence with either
with physiological dependence or without physiological dependence.
• Pgs: 192-197 can further explain the substance dependence and the sixcourse specifiers and four remission specifiers.
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Substance Use Disorder: Substance
Abuse• Substance Abuse is a maladaptive pattern of
substance use manifested by recurrent and
significant adverse consequences related to therepeated use of substance.
• In order for an Abuse criterion to be met, the
substance-related problem must have occurredrepeatedly during the same 12-month period orbeen persistent.
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Substance Induced Disorder:
Substance Intoxication• Substance Intoxication is the development of a
reversible substance-specific syndrome due to the
recent ingestion of a substance.
• Examples of intoxication: belligerence, mood
liability, cognitive impairment, impaired judgment, impaired social or occupational
functioning
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Substance Induced Disorder:
Substance Withdrawal• Substance Withdrawal is the development of a
substance-specific maladaptive behavioral
change, with physiological and cognitiveconcomitants, that is due to the cessation of, or
reduction in, heavy and prolonged substance use.
• Withdrawal develops when doses are reduced or
stopped, whereas signs and symptoms of
Intoxication improve after dosing stops.
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Diagnostic Criteria for Substance
Dependence• A pattern of substance use, as manifested by three (or more) of the
following, occurring at any time in the same 12-month period
▫ 1) Tolerance
▫ 2) Withdrawal
▫ 3) Substance taken in larger amounts over longer periods than
intended
▫ 4) Persistent desire or unsuccessful efforts to cut down or control
substance use
▫ 5) Great deal of time spent on activities necessary to obtain drugs▫ 6) Important recreational, social, or occupational activities are
given up or reduced
▫ 7) Use is continued despite knowledge of having persistent physical
or psychological problems that have likely been caused by
substance use.
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Diagnostic Criteria for Substance
IntoxicationA) Development of a substance – specific syndrome
due to recent exposure of a substance
B) Clinically significant behavioral orpsychological changes due to the effect of thesubstance on the central nervous systemdeveloped due to recent exposure of a substance
C) The symptoms are not due to a general medicalcondition and are not better accounted for byanother mental disorder.
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Diagnostic Criteria for Substance
Withdrawal
A) Development of a substance-specific syndrome due tothe cessation of substance use that has been heavy and
prolonged
B) Development of a substance-specific syndrome causesclinically significant distress or impairment in social,
occupational, or other important areas of functioning
C) The symptoms are not due to a general medicalcondition and are not better accounted for by anothermental disorder.
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Proposed Changes in DSM-5
• 303.90 Alcohol
Dependence
• 304.40 Amphetamine
Dependence
• 304.30 Cannabis
Dependence• 304.20 Cocaine
Dependence
• 304.50 Hallucinogen
Dependence
•
305.00 Alcohol Abuse• 305.70 Amphetamine
Abuse
• 304.20 Cannabis Abuse
• 304.60 Cocaine Abuse
• 305.30 Hallucinogen
Abuse
• 304.60 Inhalant
Dependence
• 305.90 Inhalant Abuse
• 305.1 Nicotine
Dependence
• 304.00 Opioid
Dependence
•
305.5 Opioid Abuse• 304.60 Phencyclidine
Dependence
• 305.90 Phencyclidine
Abuse
• 304.80 Polysubstance
Dependence
• 304.10 Sedative,
Hypnotic, or Anxiolytic
Dependence
• 305.40 Sedative,
Hypnotic, or AnxiolyticAbuse
• 304.90 Other (or
Unknown) Substance
Dependence
• 305.90 Other (or
Unknown) Substance
Abuse
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Alcohol Abuse
• Anybody can be dependent on alcohol and there
are many factors why people abuse alcohol. But
studies prove those who abuse alcohol the most
report that they drink to relieve emotional andsocial problems.
• The screening tests that are used to determine if
you have an alcohol problem is CAGE (Cut,Annoyed, Guilty, and Eye-opener) or TWEAK
(Tolerance, Worried, Eye-opener, Amnesia, and
Kut)
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Treatment Plans• Behavioral Treatments-
Behavioral treatmentshelp patients engage in thetreatment process, modify
their attitudes andbehaviors related to drugabuse, and increasehealthy life skills.
• Residential treatment-Treatment programs inwhich the client stays at arehabilitation or chemical
dependency facility.
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Medications
• Opioids: Methadone, buprenorphine and, forsome individuals, naltrexone are effective
medications for the treatment of opiate
addiction.• Tobacco: A variety of formulations of nicotine
replacement therapies now exist — including
the patch, spray, gum, and lozenges — that are
available over the counter. In addition, two
prescription medications have been FDA-
approved for tobacco addiction: bupropion and
varenicline.
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Medications continued
• Alcohol: Three
medications have
been FDA-approved for
treating alcohol
dependence:naltrexone,
acamprosate, and
disulfiram.
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Community Resources
• The Council for Alcohol and Drugs in Houstonhttp://www.council-houston.org/Public/index.asp
•
Texas Department of Health & Human Serviceshttp://www.dshs.state.tx.us/sa/Cont_Res/SubstanceAbuseLinks.shtm
• National Substance Abuse Resource Index
http://nationalsubstanceabuseindex.org/
• National Institute on Drug Abusehttp://www.nida.nih.gov/infofacts/treatmeth.html
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Community Resources•
Memorial Herman Prevention and Recovery Centerhttps://www.mhparc.org/
• The Right Step Rehabilitation and Chemical Dependency Facilityhttp://www.rightstep.com/
• The Odyssey House- Adolescent Substance abuse treatmenthttp://www.odysseyhousetexas.com/
• Cheyenne Center- Residential & Outpatient chemical dependencytreatment for men
http://www.cheyennecenter.com/residential.asp
• Santa Maria Hostel- Residential & Outpatient chemical dependencytreatment for women with children
http://www.santamariahostel.org/
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Case Vignette:
• Intervention Clip:
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References
• Kuhn, C. Swartzwelder, S. and Wilson, W. (2008). Buzzed: The straight facts about
the most used and abused drugs (3rd Ed.). New York: Norton.
• American Psychiatric Association. (2000). Diagnostic and statistical manual of
mental disorders: DSM-IV-TR, (4th
ed.). American Psychiatric Association. ( DSM IV).
• Gray, S.W. & Zide, M.R. (2008). Psychopathology: A competency-based
assessment model for social workers. Brooks and Cole.
• National Institute on Drug Abuse. (2009). Treatment approaches for drug addiction.
Retrived on September 23, 2011: http://nida.nih.gov/Infofacts/treatmeth.html